About 10% of people have an arousal disorder.
Older men and women are more likely to experience arousal difficulties, and about half of people who see a clinician for a sexual dysfunction primarily complain of arousal problems.
In female sexual arousal disorder (inaccurately called frigidity), women cannot develop the physical changes of sexual arousal: increased blood flow and lubrication of the genitals.
Some women can produce these changes but lose them before completing sexual activity.
Often they are unable to develop sexual desire or achieve orgasm, and they may lack a subjective feeling of sexual arousal.
If intercourse is painful, they may avoid sexual activity, with negative consequences for marriage.
Symptoms of female sexual arousal disorder may accompany the physiological changes accompanying menopause, nursing, and certain medical disorders, including diabetes.
Clinicians do not diagnose this disorder if the symptoms are due exclusively to physiological causes.
The male form of sexual arousal disorder is called male erectile disorder (formerly impotence), in which men are unable to produce an erection firm enough for sexual intercourse.
Some men produce an erection but lose it either upon attempting to penetrate the vagina or during intercourse.
Most men with this disorder are able to produce a reliable erection while masturbating, and nearly all have erections during REM dreams, although they may not be aware of it.
Erectile disorder may impair marriage, preventing consummation and causing infertility.
It is associated with low sexual desire and premature ejaculation.
The overwhelming majority of men with erectile disorder have previously experienced no such difficulty, and many find that the problem occurs only in certain situations or when the relationship is poor.
Others have problems only with women whom they deeply love.
Symptoms may happen in episodes separated by periods of normal function.
Between 15% and 30% of the time the symptoms disappear without treatment.
Medication for high blood pressure, diabetes, and chronic alcoholism may impair erections.
Some form of physical or hormonal problem is suspected in the majority of men with erectile disorder, but psychological factors are nearly always involved.
If the cause is purely physiological, the man will be unable to experience an erection even during REM sleep.
Consequently, an erection during sleep indicates that psychological factors are involved.
The simplest test for erection during sleep is to apply a moistened strip of postage stamps around the base of the penis before going to bed.
An erection will break the perforations.
Sometimes, the discovery that erections occur during sleep is sufficient to end the episode of erectile disorder.
Fear, anxiety, anger, hostility, and poor communication in the relationship all contribute to arousal disorders.
A woman is particularly likely to experience problems that result from not experiencing enough variety of stimulation to learn what is most arousing for her.
If she does not know her own sexual anatomy or is unwilling to tell her partner what she wants him to do, arousal problems are more probable.
Since the man's erection is essential for sexual intercourse, some theorists argue that the man is under considerable performance pressure.
As long as erection occurs reliably the pressure is insignificant, but once erection fails, even for medical reasons, concern increases dramatically.
Worry then interferes with erection, compounding the problem.
Treatment of sexual arousal disorders deals primarily with the relationship, after considering the possible role of physiological conditions or psychological depression.
Therapists encourage the couple to communicate about sexual activity that each person finds pleasurable.
As ignorance about sexual anatomy and behavior often contributes to arousal problems, clinicians will typically provide information about effective sexual behavior to the couple.
Education about female sexual anatomy and responsiveness is intended to help the woman communicate her needs and to enable the man to be a more effective and sensitive lover.
Behavioral therapists may recommend sensate focus, in which partners take turns touching each other without sexual arousal being expected.
In order to develop sensitivity to nongenital stimulation and to reduce anxiety about sexuality, they do not touch genitals or breasts.
A few days later the couple begins genital stimulation, with no expectation of an erection.
Erections that do occur are allowed to subside before touching resumes, and the couple learns that they can produce an erection.
Older men with erectile difficulties may require a longer period of stimulation and no other treatment.
Especially after menopause, women may find that a water-based lubricating jelly is an adequate solution.
Some interventions are effective when physical problems cause an arousal disorder.
Hormone therapy or changes in medication may help.
For men, the drug yohimbine may be taken by mouth, and various medications may be injected directly into the penis to produce an erection.
Microsurgery to repair constricted blood vessels is sometimes effective.
Various surgical methods to produce erections through implants or pumps frequently work well, but they have drawbacks.
None of the physical methods produce long-term success if the relationship is contributing to the disorder, so psychological factors must always be considered.
Older men and women are more likely to experience arousal difficulties, and about half of people who see a clinician for a sexual dysfunction primarily complain of arousal problems.
In female sexual arousal disorder (inaccurately called frigidity), women cannot develop the physical changes of sexual arousal: increased blood flow and lubrication of the genitals.
Some women can produce these changes but lose them before completing sexual activity.
Often they are unable to develop sexual desire or achieve orgasm, and they may lack a subjective feeling of sexual arousal.
If intercourse is painful, they may avoid sexual activity, with negative consequences for marriage.
Symptoms of female sexual arousal disorder may accompany the physiological changes accompanying menopause, nursing, and certain medical disorders, including diabetes.
Clinicians do not diagnose this disorder if the symptoms are due exclusively to physiological causes.
The male form of sexual arousal disorder is called male erectile disorder (formerly impotence), in which men are unable to produce an erection firm enough for sexual intercourse.
Some men produce an erection but lose it either upon attempting to penetrate the vagina or during intercourse.
Most men with this disorder are able to produce a reliable erection while masturbating, and nearly all have erections during REM dreams, although they may not be aware of it.
Erectile disorder may impair marriage, preventing consummation and causing infertility.
It is associated with low sexual desire and premature ejaculation.
The overwhelming majority of men with erectile disorder have previously experienced no such difficulty, and many find that the problem occurs only in certain situations or when the relationship is poor.
Others have problems only with women whom they deeply love.
Symptoms may happen in episodes separated by periods of normal function.
Between 15% and 30% of the time the symptoms disappear without treatment.
Medication for high blood pressure, diabetes, and chronic alcoholism may impair erections.
Some form of physical or hormonal problem is suspected in the majority of men with erectile disorder, but psychological factors are nearly always involved.
If the cause is purely physiological, the man will be unable to experience an erection even during REM sleep.
Consequently, an erection during sleep indicates that psychological factors are involved.
The simplest test for erection during sleep is to apply a moistened strip of postage stamps around the base of the penis before going to bed.
An erection will break the perforations.
Sometimes, the discovery that erections occur during sleep is sufficient to end the episode of erectile disorder.
Fear, anxiety, anger, hostility, and poor communication in the relationship all contribute to arousal disorders.
A woman is particularly likely to experience problems that result from not experiencing enough variety of stimulation to learn what is most arousing for her.
If she does not know her own sexual anatomy or is unwilling to tell her partner what she wants him to do, arousal problems are more probable.
Since the man's erection is essential for sexual intercourse, some theorists argue that the man is under considerable performance pressure.
As long as erection occurs reliably the pressure is insignificant, but once erection fails, even for medical reasons, concern increases dramatically.
Worry then interferes with erection, compounding the problem.
Treatment of sexual arousal disorders deals primarily with the relationship, after considering the possible role of physiological conditions or psychological depression.
Therapists encourage the couple to communicate about sexual activity that each person finds pleasurable.
As ignorance about sexual anatomy and behavior often contributes to arousal problems, clinicians will typically provide information about effective sexual behavior to the couple.
Education about female sexual anatomy and responsiveness is intended to help the woman communicate her needs and to enable the man to be a more effective and sensitive lover.
Behavioral therapists may recommend sensate focus, in which partners take turns touching each other without sexual arousal being expected.
In order to develop sensitivity to nongenital stimulation and to reduce anxiety about sexuality, they do not touch genitals or breasts.
A few days later the couple begins genital stimulation, with no expectation of an erection.
Erections that do occur are allowed to subside before touching resumes, and the couple learns that they can produce an erection.
Older men with erectile difficulties may require a longer period of stimulation and no other treatment.
Especially after menopause, women may find that a water-based lubricating jelly is an adequate solution.
Some interventions are effective when physical problems cause an arousal disorder.
Hormone therapy or changes in medication may help.
For men, the drug yohimbine may be taken by mouth, and various medications may be injected directly into the penis to produce an erection.
Microsurgery to repair constricted blood vessels is sometimes effective.
Various surgical methods to produce erections through implants or pumps frequently work well, but they have drawbacks.
None of the physical methods produce long-term success if the relationship is contributing to the disorder, so psychological factors must always be considered.